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Do fat-burning supplements really work?

Dr. Spencer Nadolsky is a practicing medical physician. He is based in Suffolk, Virginia.

First things first. The most effective way to burn excess body fat is through a structured resistance training and nutrition plan. No one has ever got lean through just taking a few fat-burning pills each day, no matter what those late-night infomercials claim. Think about it: if they did, we would all be walking around looking like an Abercrombie & Fitch model all year round.

The phrase ‘fat-burning supplement’ is really an umbrella term that covers various specific compounds that either increase the metabolic rate or promote thermogenesis – the process of heat production in the body – and also includes compounds that act to prevent nutrient uptake or suppress the appetite, so can result in weight loss despite not having inherently fat-burning effects.

A key consideration when supplementing multiple compounds for any health benefit is how different substances work together, and this is especially the case with fat-burners, many of which are stimulants. Stimulant compounds can be synergistic, which means that even low doses can provide powerful effects when taken with other supplements.

Here’s what we you need to know about different supplement stack options. After them is all the details about each individual compound and how it works.

If you have little to no stimulant experience
Take 100mg to 400mg of caffeine until tolerance builds up, then add synephrine (two doses of 10mg each) and white willow extract (two doses of 90mg of salicin each). People not used to caffeine should start at the low end of the dosage range. After synephrine and white willow extract are added, the caffeine dose should be changed to two doses of 150mg to 200mg each.|

If you have stimulant experience
Take caffeine (two doses of 200mg each) and synephrine (two doses of 20mg each), with white willow extract (two doses, each of 90mg of salicin). Maintain this supplement protocol for a week then introduce yohimbine (2.5mg, twice a day, increasing to 2.7mg, twice a day, halfway through the week). Add Coleus forskohlii if 7.5 mg of daily yohimbine causes no significant side effects.

If you want to burn fat with minimal stimulation
Take caffeine (two doses of 150mg to 200 mg each) and synephrine (two doses of 10mg each). Caffeine can be supplemented by itself until tolerance sets in, at which point synephrine can be added. Once you are accustomed to both supplements, add Coleus forskohlii (two daily doses of 25mg of forskolin).

If you want appetite suppression
Take caffeine (two doses of 150mg to 200mg each) and synephrine (two doses of 10mg each). After a week of supplementation, add 5-HTP (two doses of 150mg each, increasing to 250mg over a week). Do not use 5-HTP alongside other supplements or pharmaceuticals that influence serotonin.

Stimulation supression
Around 200mg of L-theanine, supplemented alongside caffeine, can reduce the hyperactivity caused by stimulation while retaining the benefits to attention span and focus. Since caffeine is taken twice a day, the total daily dose for L-theanine is 400mg. Also, synephrine can be replaced with bitter orange extract in any stack. However, some of the flavonoids in bitter orange extract may interact negatively with other pharmaceuticals.

Here’s how each fat-burning supplement works.

Caffeine
Caffeine has several potentially beneficial effects. It is not just a powerful stimulant, it is also a fat burner. Upon consumption caffeine causes adrenaline and dopamine to be released, which improves mood, induces euphoria and increases excitability. However, after prolonged supplementation, these effects fade and only the ability to ward off sleep remains.

Caffeine has two distinct effects that contribute to its fat-burning properties. Caffeine consumption has a thermogenic effect, which means it increases heat production. Prolonged consumption of caffeine also has a lipolytic effect, which means caffeine causes triglycerides to release fatty acids, which can then be used for fuel by the body.

Caffeine supplementation can inhibit enzymes called phosphodiesterases (PDEs). Suppressing PDEs can increase levels of cyclic adenosine monophosphate (cAMP) in the body, which is associated with lower triglyceride levels in fat cells, as well as improved protein synthesis in muscle cells. Moreover, if PDEs are inhibited, supplements that increase cAMP levels, such as synephrine, might be even more effective at increasing heat production.

Despite its common usage, caffeine should not be used alongside pharmaceuticals such as monoamine oxidase inhibitors (MAOIs) – a type of antidepressant – and medications like tizanidine or dipyridamole to avoid negative interactions with these medications.

How to take it To supplement caffeine for a prolonged period of time, take 100mg to 200mg twice a day, for a daily dose range of 200mg to 400mg. People unused to caffeine should start at the low end of the dosage range, and supplementing caffeine in the evening can disrupt sleep.

People sensitive or new to stimulants should supplement caffeine by itself before introducing other stimulants, including synephrine. Caffeine can be consumed in the above doses through coffee or tea. Anyone that gets enough caffeine through dietary sources does not need to supplement caffeine.

Synephrine
Synephrine, specifically, p-synephrine, is a compound found in citrus fruits, although only bitter oranges have a high enough synephrine concentration to have an effect on the body. When consumed it causes a stimulatory and fat-burning effect by affecting the dopamine, adrenaline, and noradrenaline systems. However, it is considered an unproven supplement despite all the above evidence because it has mostly been studied on the overweight and obese.

When used carefully, p-synephrine is safe and can cause a mild increase in metabolic rate. It should be noted that this applies to p-synephrine. Other variants, like o-synephrine and m-synephrine, have less evidence for their safety. Supplementing it over a long period of time will not diminish its fat-burning effects, though the feeling of stimulation may fade over time. Some compounds in bitter oranges, such as hesperidin, may interact with drug-metabolising enzymes, and synephrine can also interact negatively with MAOIs.

How to take it The standard synephrine dose when taken alongside other stimulants is 10mg to 20mg, taken twice a day for a total daily dose of 20mg to 40mg. Anyone supplementing synephrine with other stimulants should start at the low end of the dosage range and slowly work up to avoid over-stimulation. Synephrine should be supplemented on an empty stomach in the morning, and again six to eight hours later. If this causes nausea, take it with a meal instead.

White willow bark
White willow bark is a plant source of salicin, which is metabolised into salicylic acid, a cousin of acetylsalicylic acid, better known as aspirin. Salicylic acid is very similar to aspirin with the only significant difference being that aspirin is less harmful when taken in excess. Salicylic acid can inhibit prostaglandin production in neurons, which can improve stimulatory signaling and increase the effects of adrenaline.

It has a number of potentially negative interactions with other drugs. As an antiplatelet agent, it may interact negatively with other blood thinners, such as warfarin. It should not be supplemented by people with stomach ulcers. It may be more effective at improving the effects of synephrine and caffeine in people with a higher body-fat percentage compared to lean users.

How to take it White willow extract is ideally supplemented alongside synephrine and caffeine. It can be taken at the same time as these two, and the combination can be taken with a meal to lessen the side-effects of heartburn or an upset stomach. The standard dose for white willow extract is based on the extract’s salicin content. This translates to 90mg of salicin. For example, to supplement 90mg of salicin through a white willow extract containing 15% salicin, take 600mg.

Coleus Forskohlii
Coleus forskohlii is a herbal supplement that can elevate cyclic adenosine monophosphate (cAMP) levels, one of the molecules responsible for the feeling of stimulation from supplements such as caffeine.

Elevated cAMP levels are associated with lower triglyceride levels in fat cells and increased protein synthesis in muscle cells. Preliminary evidence suggests Coleus forskohlii supplementation can cause both of these effects, though there is currently no evidence that links Coleus forskohlii supplementation and muscle gain. Coleus forskohlii can be taken alongside other supplements that increase cAMP, such as caffeine, to increase their effectiveness. Coleus forskohlii supplementation should not last longer than 12 weeks. More research is needed to determine the long-term effects, but short-term use has been shown to be safe. Do not supplement Coleus forskohlii if you are currently taking blood pressure medications or blood-thinning medication. More research is needed to confirm that this is the ideal dose and overweight people may experience more benefits than lean people.

How to take it The main bioactive compound in Coleus forskohlii is called forskolin. Most Coleus forskohlii extracts contain 10% forskolin by weight. The standard dose for forskolin is 50mg, taken in 25mg doses twice a day about four to six hours apart. To supplement 25mg of forskolin, assuming a 10% forskolin Coleus forskohlii extract, take 250mg.